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What does a mysterious school illness tell us about our anxieties?

In Sideways, Matthew Syed explores ideas that shape our lives through stories of seeing the world differently. In The Social Contagion, he looks into a strange fainting outbreak at a school, and other similar events, which can affect dozens, sometimes hundreds of people.

Can illness really spread instantly through social networks, felling us like dominoes, or is there a psychological explanation? And can our desire to explain such phenomena rationally lead to us explaining them away?

The mass fainting at Outwood Academy

On Armistice Day 2015, Mel got a phone call from her son’s school, asking her to come in. When she arrived, she found the car park filled with ambulances and police cars, emergency services buzzing around.

It all started in the morning assembly. “Somebody collapsed, or fainted, or threw up – or a combination of the above,” says Mel. And there was a domino effect. More teenagers begin to faint. The pupils were all sent back to their classrooms but more began to complain of feeling dizzy and nauseous, across the site.

And then rumours began to spread. The kids started to speculate about a gas leak or contaminated water. “Then someone else said some chemical had leaked,” Mel recalls.

Fire crew and hazmat teams began to scour the school for toxic substances. Specialists monitored and ran tests on the pupils who had fallen ill to try to find the cause of the mysterious illness. But every line of enquiry came back with nothing. The children recovered, the emergency services deemed the school safe, and everything returned to normal.

But an event like this – children and teenagers collapsing left, right and centre for no obvious reason – had happened before…

"There seems to be a domino effect… and then the illness spreads"

Matthew explains how the events at Outwood Academy unfolded.

“I started to look around for more examples and started to collect them”

In July 1980, at Hollinwell Showground near Nottingham, hundreds of children gathered for a jazz band competition. A wave of illness spread across the festival, with dozens of children fainting.

The event was written up in a medical journal where it captured the attention of a young student. Professor Sir Simon Wessely, now psychiatrist and epidemiologist at King’s College London, became captivated by these strange outbreaks and how they spread, because they all followed a similar pattern.

“Usually, it will take place in a fairly crowded atmosphere,” says the psychiatrist. This might be a school hall, or a marching band, where there are lots of people close together. “And often it will happen when people are getting slightly uncomfortable.” It might be too warm, or claustrophobic.

“Suddenly someone sees someone who they know who’s suddenly just keeled over,” he explains, and instead of concluding it’s a hot day, let’s not worry, they begin to think that something strange is occurring. “And then there’s something else happening: there’s a strange noise outside in a field, or there’s something wrong with the air conditioning that day, or maybe there’s a funny smell, and then very quickly what happens is people start to get anxious.”

It’s not a toxin or a poison which is causing the wave of illness, it’s people’s minds

“When you get anxious you get absolutely classic symptoms,” says Wessely. “You start to produce adrenaline and then your heart gets a bit faster, you get butterflies in your stomach, you sweat a bit.”

Once a crisis takes hold it can spread like wildfire.

“This can happen in almost fractions of seconds,” he explains. Then suddenly the person next to you is getting anxious, they get the same symptoms, someone else collapses, and you have an incident which has gone from being a single person falling over, to many. “This can spread so fast,” he says, “you might have hundreds involved.”

And if the emergency services are understandably called to treat people, they can have a compounding effect on the outbreak. “You have people running around, you have the ambulances being called,” says Wessely, “all of which are absolutely calculated to increase your anxiety, not decrease it.”

Once a crisis takes hold it can spread like wildfire.

“Spread is more likely with people that you know”

Psychologists call this “mass sociogenic illness”. But it used to be known by a more familiar name: mass hysteria.

It’s a bit more complicated than a wave of panic and screaming, because people genuinely feel unwell. And it’s our social connections that make us more vulnerable to this curious phenomenon.

“Spread is more likely with people that you know,” says Wessely. “It goes through your own social networks… Having a social connection with the person who’s suddenly collapsed in front of you, certainly increases the chance of transmission.”

When there is existing stress, the outbreaks are more likely

In 2012, press reported a case of ‘mass hysteria’ breaking out at a girls’ school in Afghanistan, where 125 girls were taken to hospital after complaining they’d been poisoned. The wave of mass sociogenic illness began almost a decade before. Girls kept feeling ill in different schools, on different days, for years, all adding fire to the flames of suspicion that this was some kind of calculated attack.

Many believed that outbreaks were a targeted attack by the Taliban because of their opposition to girls’ education – despite authorities investigating and informing pupils, parents and the press that there was nothing to worry about. A WHO report on 22 separate outbreaks in the country came to the same conclusion: there was no evidence of a poison attack. But it’s not surprising that young girls, who had grown up with the Taliban looming in the background, might experience high levels of anxiety.

“Where there is existing stress, which leads you to be monitoring what’s going on, you’re more aroused, you’re more alert, you pay more attention also to your own body and your own bodily symptoms,” says Wessely. “All of these things are symptoms of high anxiety and arousal. And all of them are perfectly calculated to make these episodes either more frequent, more dramatic or more prevalent.”

In labelling these events as psychological, we risk ignoring the real-world triggers

When we see the label mass hysteria, or mass sociogenic illness, we might think the problem is all in the mind. And there’s a risk we ignore legitimate, real-world concerns that could be triggering the anxiety.

Take the climate crisis, for example. “Now we have so much coverage on the idea of eco-anxiety,” says Dr Johanna Braun, artist and researcher at the Academy of Fine Arts, Vienna. In Germany the term of the year in 2019 directly translated as ‘climate hysteria’. “It’s where young people are so concerned about the state of the earth, that they have all kinds of medical symptoms that express themselves, and then they are labelled as hysterical,” explains the researcher.

Fears for the future of our planet are now so potent for some, that they are causing medical symptoms of anxiety. And if we confine eco-anxiety to the realms of pure psychology, we run the risk of underestimating or dismissing the real cause.

By explaining away mass sociogenic illness, we can overlook the social conditions that lead to the contagious anxiety – and fail to appreciate the relationship between mind and body, and between ourselves and the world.

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